Stomatologics Stomatological preparations lPreparations for treating teeth, periodontium and oral mucosa lMostly local application lClassified according to indications Preparations for therapy of oral mucosa diseases •antiflogistics, antiseptics, adstringents, mucolytics, antimycotics, ATB, antivirotics and imunomodulants •Forms: solutions, ointments, pastes and gels •adhesive compounds – polymeres: acrylic acid, carmellose •Temporary applications •Mull soaked with medicament Chronical gingivitis lInadequate oral hygiene, lgingival irritation by plaque ladstringents, antiflogistics, antiseptics: –Chlorhexidine (eg. Oral-B), benzydamine (eg. Tantum Verde) (solution, spray or pastilles) –10% Burrow solution (aluminium acetate) or aluminium acetotartrate –tannin 2-5 % , herbal adstringents (salvia, tormentilla) –chamazulene, bisabolol (chamomile) Chronical gingivitis Prescribe spirituous oral solution (100,0 ml) for rinsing oral cavity, containing 0,2 % of methol and 20 % of aluminium acetotartratis solution. Recommend patient to dissolve 10-15 drops in glass of luke-warm water and rinse mouth. Chronical gingivitis Prescribe 50,0 ml of water solution containing 4 % of tannin and 30 % of glycerol. Solution for massage of gums. l l 50,0 ml of water solution, 4 % of tannin and 30 % of glycerol. Solution for massage of gums. Rp. Salviae folii 50,0 D.S. prepare tea (1 tea-spoon into 1 cup of water) for rinsing mouth Salvia for rinsing l l l Stomatitis aphtosa l immunological impair, insufficience of B6 or folic acid lTherapy: argenti nitras 2-5%, methylthioninii chloridum 2%, methylrosanilinii chloridum 2%, hexetidine (Stopangin), iodine solutions (Jox, Jodisol), chlorhexidine lLocal anaesthetics, corticoids Rp. Argenti nitratis 2,0 Aquae purificatae ad 100,0 M. f. sol. D. ad lag. fusc. S. Oral solution for aphtous ulcers. Apply on afflicted spot once a day. Antiseptics for spreading on mucosae lRp. lMethylrosanilinii chloridi 1,0 lEthanoli 60% 5,0 lGlyceroli 85% 5,0 lAquae purificatae ad 50,0 lM. f. sol. lD. ad vitr. lS. Apply on oral mucosa several times a day. l l Gingivitis ulcerosa Rp. Hydrogenii peroxidi 30% 50,0 Aquae purificatae ad 250,0 M.f.liquidum D.ad lagenam fuscam S. 1 spoon in glass of water, rinse mouth several times a day l anaerobic microflora of subgingival plaque → painful ulcerations (G- rod-shaped bacterias: Bacteroides, Prevotella, Fusobacterium, Spirochetes) l most often in young population Therapy: 6 % hydrogen peroxide, hexetidine (Stopangin), chlorhexidine (Corsodyl), iodophores (Jox) l in chronic development - ATB and antimicrobial chemotherapeutics (metronidazole, linkosamides, tetracyclines, macrolides) l l Stomatitis herpetica l HSV 1 l intraepithelial vesicles on gingiva, painful, edematous l risk of generalisation (in imunosuppressed) l Therapy: symptomatic – vit. C and B LA (lidocain, trimecain) before meals rinsing (Herbadent) exceptionally systemic virostatics (aciclovir - Herpesin) l KI: corticosteroids Stomatitis herpetica recidivicans l reactivation of latent HSV infection, erosions without vesicles, edema, erythema l Therapy: similar to primary stomatitis herpetica Herpes labialis l flare up of HSV infection l Therapy: in prodromal phase locally applied aciclovir, penciclovir l l Candidosis, soor Rp. Natrii tetraboratis decahydrici 2,0 Glyceroli 85% ad 50,0 M.f.liquid. D.S. apply on oral mucosa 3x per day l Candida infection l predispositions: dysmicrobia, insufficient oral hygiene, DM, imunosuppresion, nutrient deficits, dentures.. l Therapy: animycotics locally and systemicaly (Ketoconazole, nystatin, natamycine), sodium tetraborate glycerol 4% (borax glycerol) Antimycotic therapy of oropharyngeal cavity lRisky in long-term therapy with ATB, antibacterial chemotherapeutics, inhalant corticosteroids, DM lLocally applied antiomycotics (+ combination with systemic antimycotics) lclotrimazole (Canesten tbl.buc) lmikonazole (Daktarin gel. por.) lnystatin l l Stomatitis angularis (cheilitis angularis) „cheilosis, perlèche“ – infections: Candida albicans, oral microflora - other causes - allergies, low-iron anemia, celiakia, insufficience of B2 lTherapy: natamycin, chloramphenicol, Framykoin, vit. B (riboflavine) –Combination of ATB + antimycotics + corticoid (Pimafucort) Argenti nitras 3%, Ac. salicylici 2%; Rp. Acidi salicylici 0,4 Zinci oxidi unguenti ad 20,0 M.f.ung. D.S. Ointment for labial commissure. Apply several times a day. lPtyalism (sialorrhea) l lExcessive production of saliva (mucosal irritation, injuries of jaw, Parkinson disease, heavy metal intoxication, psychiatric diagnoses) lTherapy: PS-lytics Saliva production impair I. Saliva production impair I. - atropine sulphate monohydrate (0,0005g) lXerostomia lReduced salivation (PSL, anti H1, diuretics, tranquillisers, radiotherapy) l lTherapy: PS-mimetics, solution of 0,5% carmellose (carboxymethyl cellulose = cellulose gum) Saliva production impair II. Saliva production impair II. Rp. Pilocarpini hydrochloridi 0,15 Lactosi monohydrici q.s. M. f. pulv. Div. in dos. aeq. No XXX (triginta) D. ad caps. gelat. S. 3x per day swallow 1 capsule - pilocarpine hydrochloride 0,005g - 0,5 % water solution of carmellose Antiseptics and disinfectants lBenzalkonii chloridum – Septolette lChlorhexidin digluconas – Septofort lBenzydamini hydrochloridum – Tantum Verde (antiflog.) lBenzoxonium chloridum – Orofar lCetylpyridinium chloridum – Neo Septolette lDichlorobenzenmethanol – Neoangin, Strepsils (2-slož.) Antibacterial therapy of oropharyngeal cavity • locally administered ATB • bactericidal drugs Fusafungin (Bioparox) For local therapy, G+ I: tonsillitis, rhinnitis, sinusitis, tracheitis, laryngitis, pharyngitis, bronchitis Hexetidin (Stopangin) bacteriostatic and fungistatic chemotherapeutic Prescription Isotonic glucose solution for infusion l- 3 bottles, ½ l each Saline solution for infusion l- 2 bottles, ½ l each §topical – extraction, ¯ gag reflex §infiltration §block l - lidocain (Xylocaine) l - trimecain (Mesokain) Local anaesthetics stomatosurgery (treatment of pulpitis, vital amputation and extirpation of pulp, alveolar trepanation) L.A. for topical anaesthesia in oral cavity Trimecaini hydrochloridi 0,4 Aquae pro iniectione ad 10,0 Epinephrini tartratis 1:1000 gtts. No. X (decem) M.f. sol. D.t.d. No. X (decem) ad ampullas. Sterilisetur! S. Cum formula. Ad usum medici. L.A. for plexus blockage lRp. l Procaini hydrochloridi 0,2 l(Trimecaini hydrochloridi) l Aquae pro iniectione ad 10, 0 l Epinephrini tartratis 1:1000 gtts. No. V (quinque) l M.f.sol. l D.t.d. No XX (viginti) ad ampullas l Sterilisetur! l S. Cum formula. Ad usum medici.